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Risk Factors for Classical Kaposi Sarcoma on a Population-based Case-control Study in Sicily

  1. Author:
    Anderson, L. A.
    Lauria, C.
    Romano, N.
    Brown, E. E.
    Whitby, D.
    Graubard, B. I.
    Li, Y.
    Messina, A.
    Gafa, L.
    Vitale, F.
    Goedert, J. J.

  2. Author Address

    Anderson, Lesley A.] NCI, Infect Immunoepidemiol Branch, Div Canc Epidemiol & Genet, Rockville, MD USA. [Anderson, Lesley A.] Queens Univ Belfast, Ctr Pub Hlth, Belfast BT7 1NN, Antrim, North Ireland. [Lauria, Carmela, Gafa, Lorenzo] Lega Italiana Lotta Contro & Tumori Sez Ragusa, Ragusa, Italy. [Romano, Nino, Vitale, Francesco] Univ Palermo, Dipartimento Sci Promoz Salute GD Alessandro, Sez Igiene, Palermo, Italy. [Brown, Elizabeth E.] Univ Alabama, Dept Epidemiol, Birmingham, AL USA. [Brown, Elizabeth E.] Univ Alabama, Dept Med, Birmingham, AL 35294 USA. [Brown, Elizabeth E.] Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA. [Whitby, Denise] NCI, Viral Oncol Sect, AIDS & Canc Virus Program, SAIC Frederick, Frederick, MD 21701 USA. [Messina, Angelo, Goedert, James J.] Univ Catania, Dipartimento Sci Biomed, Catania, Italy.
    1. Year: 2008
  2. Journal: Cancer Epidemiology Biomarkers & Prevention
    1. 17
    2. 12
    3. Pages: 3435-3443
  4. Type of Article: Article
  1. Abstract:

    Background: Classical Kaposi sarcoma is a rare complication of Kaposi sarcoma-associated herpes virus (KSHV) infection. We conducted a population-based, frequency-matched case-control study in Sicily to further investigate the reported inverse relationship between smoking and classical Kaposi sarcoma and to identify other factors associated with altered risk. Methods: All incident, histologically confirmed classical Kaposi sarcoma cases in Sicily were eligible. A two-stage cluster sample design was applied to select population controls. KSHV seropositivity was determined using four antibody assays (K8.1. and orf73 enzyme immunoassays and two immunofluorenscence assays). Using SAS-callable SUDAAN, we compared the characteristics of classical Kaposi sarcoma cases and KSHV-seropositive controls. Odds ratios (OR) and 95% confidence intervals (CI) are presented. Results: In total, 1.42 classical Kaposi sarcoma cases and 1.23 KSHV-seropositive controls were recruited. Current cigarette smoking was associated with reduced risk of classical Kaposi sarcoma amongst males (OR, 0.20, 95% CI, 0.06-0.67). Edema was associated with classical Kaposi sarcoma, but only when it presented on the lower extremities (OR, 3.65, 95% CI, 1.62-8.23). Irrespective of presentation site, diabetes and oral corticosteroid medications were associated with increased risk (OR, 4.73, 95% CI, 2.02-11.1 and OR, 2.34, 95% CI, 1.23-4.45, respectively). Never smoking, diabetes, and oral corticosteroid medication use were all independently associated with classical Kaposi sarcoma risk. Discussion: We confirmed previous reports that cigarette smoking was associated with a reduced risk of classical Kaposi sarcoma, and we found that risk was lowest among current smokers. We also found that classical Kaposi sarcoma risk was strongly and independently associated with oral corticosteroid use and diabetes. Corroboration of these observations and investigation of possible underlying mechanisms are warranted. (Cancer Epidemiol Biomarkers Prev 2008,17(12):3435-43)

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  1. PMID: 19064559

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